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38 RAYMOND RD - BUILDING INSPECTION 0 The Commonwealth of\Massachusetts OF Board of Building Regulations and Standards CITY SALE M M Massachusetts State Building Code, 780 CNIR Revised Mar 2011 Building Permit Application To Construct, Repair, Renovate Or Demolish a One- or Two-Family Dwelling [his Section For Official Use Only Building Permit Number: IJa ppi v � Building Official(Print Name :'Signature Date. SECTION L•SITE INFORNIAXIO 1.1 Property Address: p 1.2 Assessors Map& Parcel Numbers 1.l a Is this an accepted street?yes_ no Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sq ft) Frontage(ft) 1.5 Building Setbacks(It) Front Yard Side Yards Rear Yard Required Provided Required Provided Required Provided 1.6 Water Supply: (M.O.L c.40,§54) 1.7 Flood Zone Information: 1.8 Sewage Disposal System: Public❑ Private❑ Zone: _ Outside Flood Zone? Municipal❑ On site disposal system ❑ Check if yes❑ sECTION1:, PROPERTY'OWNERSWP 2.1 Owner'of Record: Gt2i4[^t (�r� Rn/ CHAi✓a a Pz ST Name(Print) City,State,ZIP &-7 No. and Street Telephone Email Address SECTION 3: DESCRIPTION OF PROPOSED WORW(check all that apply). New Construction ❑ Existing Building❑ Owner-Occupied ❑ 1 Repairs(s) grf Alteration(s) ❑ 1 Addition ❑ Demolition ❑ Accessory Bldg. ❑ Number of Units, I Other ❑ Specify: Brief Description of Proposed Work: 2F-nAC /E hln/p n/STALI /liC1iJ �DFlt�i t�L> SECTION 4: ESTINLkTED CONSTRUCTION COSTS Estimated Costs: Item Official Use Only, , Labor and Materials 1. Building 1. Building Permit Fee: S ° IndieSie how fee is determined: 2. E(zctrical $ ❑ Standaid..City/'CowmApplication Fee ❑Total Pioject Cost 3,(Item6)x multiplier x 3. Plumbing S 2. Other Fees: 3 I. %-lechanical (HV.\C) S List: 5. Mechanical (Fire S Sit cession) •total Ml Fees: .S_ Check No. Check Amount: _Cash Amount. 6. Total Project Cost: 3 ❑ Paid in Fnll ❑Outstanding Valance Dua: �, � � r SECTION 5: CONS't-RUC'1'ION SERVICES r-3 Construction Supervisor License(CSL) Number ate � License Numbcr E.epiratimt Date ic of CSL Ifolder List CSL Type(see below) 'C7° 7� V—".U(FS CLIF 'Type - Description No. and Street U Unrestricted Duild419 s Up to 35,000 cu. It. E�f3DPt, �14 ©1460 R Restricted 1&2Famil Dwelling City,Town, State, VI blasonr RC Roofing Covering WS W indow and Siding SF Solid Fuel Burning Appliances ye, � UFS� �At)ST`/t/Od'1�l,g/{LjS� Covet I Insulation ' ee,e hone Email address D Demolition 5.2 Registered Home Improvement Contractor(I1IC) [D 99 53 M rit;0r5 C2W-r12 UC 1re 0 tN/ L L c, MC Registration Number Expiration Date I lIC Company Name or It IC Registrant Nmme tZL��lit/i<✓Gs G'�2 �sv�r�� �� aAvs7;i✓a�EGoa��s�/ e-OA4 No fd?S& 0 OE// Email address City/Town,State, ZIP Telephone SECTION 6: WORKERS' COMPENSATION INSURANCE AFFIDAVIT(M.G.L. c. 152. § 25C(6)) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the Issuance of the building permit. Signed Affidavit Attached? Yes .......... ❑ No ........... ❑ SECTION 7a: OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNER'S AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property, hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application. Print Owner's Name(Electronic Signature) Date By 7SECTION 7h: OWNEW OR AUTHORIZED AGENT DECLARATION enteringe below, I hereby attest under the pains and penalties of perjury that all of the information lication is true and accurate to the best of my knowledge and understanding. rited:\gentb Name(Electt'onie Signature) Date NOTES: I. :\n Owner who obtains a building permit to do his/her own work, or an owner who hires an unregistered contractor (not registered in the Home Improvement Contractor(HIC) Program), will not have access to the arbitration program or guaranty find under\[.O.L. c. I42A. Other important information on the 111C Program can be found at ta oea Information on the Construction Supervisor License can be found at wwvw.mass.gntyd(I/(IL 2. When substantial work is planned, provide the information below-. Total tloor area(s(l. It.) _ (including garage, finished basement/attics, decks or porch) tirosi living area(sq. ft.) _ Habitable room count Numbcr of tit oplaccs--- Number of bedrooms _ —— ---_-- Numberol'bathroonts NumberoFhalt-baths _ I'vpe of heating system - _--_ _--_.--- Number of decks/porches 1)peof cool ing.;yitcnt __--__—_-- Enclosed _-- --- --Open -- ------ 1. I1Hal 111oj.ct Sywtra Fuota e" utay be iubihtutol for '1',�t.d Project(bat" . .*W j ffilinRegulat�ox(O License or remotion vafid fOr todivirld use only arstn ofCdrmaladv�itws B Bmiiess Regulation ME tmPROVEMENT CONTRACTOR before the a:pirafion date. If fAoud mars to: itlm - TYPE i Office of Consumer Affairs and Business Replatioo N - S =Expiralimc &MMM LtdUabMyCapx#4.. 10ParkPlana-Soils51911 p t Boston,MA02114 AAELf CQNST.ZUCTtCN _ faustno Maki . 341ENMNG8CIR Peabody.AAA o1960 Undersecretary Not valkMwWwat sipature" Massachusetts-pepartraent of Public Safety Board of Building Regulations and Standards _- - - L'.tIIsirnchOn$apenisor Ucense:CS400393 FAt1SIRrloPillfByw� Gri 34 JENNINtS CIR 21 ody MA 019M IT Peab r..r -.Inc%, ` Expiration l."a+ 03101P1015 iomnissiond:r . . - _ A CERTIFICATE OF LIABILITY INSURANCE °2/l 4/2o1zA' 12022 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS -- CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES s BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTAIsT: N the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. H SUBROGATION IS WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsment(s). -y. PRODUCER - Lauren Goldman _3 Cross Insurance-Peabod? PHONE (978)532-5445 PAX (sva)532-2217 139 Lynnfield Street - illg ldman@crossagency.com - IMSURERM AFFORDING COVERAGE NAICIF -Y Peabody MA 01960 - UISORERA34ain Street America Assur. Cc 9939 . INSURED INSURERaNGN Insurance Co 47BB MELOS CONSTRGCTIOH LLC C/O FAUSTINO HELD e1suRExc:Travelers Indemnit o AAmerica 5666 34 JENNINGS CIR - nIwRERo: 34 Jennings Circle umuRERE: PEABODY m& 01960-3568 ILP.M F: COVERAGES CERTIFICATE NUMBERCL12121476687 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT-vISTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND-CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. v L TYPE OF INSURANCE POLICY NUMBER PIMMDIYYYYJ IMINDUATM LWRS eENEAL ur EACH OCCURRENCE E 1,000,000 ' E 500,00 L C. 0 R COMMERCIAL ES 3 A 1 CLAIMSAMDE ®OCCUR KIW3862 1/26/2012 1/26/2013 MED EXP a E 10,000 { - PERSONALBADVMURY S 1,000,000 GENERAL AGGREGATE E 2,000,000 GENI AGGREGATE DART APPLIES PER: PRODUCTS-COMPIOP AGG E 2,000,000 B Poucr 1= Loc E IRO- AUTOMOBILE LIABILITY SBOMILY INED a 11000,00 B ANY AUTO - RY(Perpvem) f ALL OWNED SSCHWUL® Hg3926 /21/2012 /21/2013 RY(Per ecddem) E AUTOS E XHIRED AUTOS AUTOSxwms UUA E 100.00 UMBRELLA UAE OCCUR EACH OCCURRENCE E IXCESS LIAR CLAIMS,,DE AGGREGATE E LIED i I RpTENnotiz E C WORKERS COMPENSATION WC TATLL OTH- AND EMPLOYBUY LIABILITY vim - ANY PROPRIETORr �ARTNEWEXECUTIVE NIA E.L. ACCIDENT E 1 OOO OOO OFFlGEWMEA®ER"MOEDT 7814N46S12 2/q/2012 2/4/2013 _ (MmrtetmY UI NH) EL DISEASE-EA EMPLO E 1,000,00 IN deeVbe under EL DISEASE-POLICY UNIT E 11000,000 o�scnwnoN of oPERAnoNs below OESC11IPnoN OF OPERATIONS I LOCATIONS I VEHICLES (A1MCl ACORD 101,AdtlIBmW Remade SeheEW4 N moie epee!Is requirvtl) Refer to policy for exclusionary endorsements and special provisions. CERTIFICATE HOLDER CANCELLATION ,3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, For Insured's Purposes AUTHORRPD REPRESENTATIVE I I { Timothy Tramonte/11131 r~1�. �LUirJro-r7ti'i ACORD 25(2010105) 9 fl 1988-2010 ACORD CORPORATION. All rights reserved. INSET$IJ,Imn51 m The ar.non mama and IA.n am rent A.a mar4e nF Ar-n0n - i' CITY OF S:U.E1I, INL1SSACHliSETTS r BuMi:tG D EP.i&r%I&NT 120 WASHIINGTON STREET, 3ie FLOOR TEL (978)745-9595 F.Ax(978) 740-9844 K1.NBE y DRISCOLI T "ViAYOR 3iOhtAS ST.PtFxR13 DIREMIt OF PUBLIC PROPERTY/BUILDLTIG CMLMISSIONER Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers linlicant Information Please Print Legibly /�y f Orr/ /--6 G .. Villlle(BuSllh'si.Ofglnirat'teNlndividual): ///GGD�' `I.:J"c5T(r'(JG7l Address: 3 C k8 A/7tu C-r 5 r^i 0— City/State/Zip:� l3��� �'14 4110KE9 Phone N: 9 73' . 53/ D 3� /I Are/you an employer?Check the appropriate boat Type of project(required): 1.117 1 am a employer with 4. 0 I am a general contractor and 1 6. ❑New construction employees(fLll and/or part-time).* have hired the sub-contractors 2.❑ I am it sold proprietor or partner• listed on the attached sheet 1 1. ❑Remodeling ship and have no employees These subcontractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance: 9. Building addition (No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their ME]Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing rcpoirs or additions myself.[No workers'camp. c. 152,$1(4),and we have no 12.❑ Roof repairs insurance required.]t employees.[No workers' 13.0 Other camp.insurance required.] -nay appllean nut checks box,r I mutt also rill out the sactiun below showing their workers'compensation policy inil rmanom 'I bvneow ar,who submil this affidavit indicating they art doing all work and thm him outside contractors most submit a now a(rldavit indicating such. :Conimron that chuck this box must mtachod an addiliunal ohms ahuwing the name of the sulg•cantracwrs and their workers'comp.policy information. /am an employer that he providing worker'compeatado t Laurance for my employees Below is the pol i y and fob site information. ,,V/ insurance Company lame: C 2 L il 05S ls U IZA/ �,E Policy 4 or Srlf•ins. Lie.4: Pf U)3 74yM t/6 5, 1 7_ Expiration Date: I7— 13 Job Site Address: la P)4 y1V Xm9 12.E City/State/2ip: SAL /Z/:::!� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration data). Failure to secure coverage as required under Suction25A of MGL c. 152 can lead to the imposition of criminal penalties of a tine up to S 1.500.00 und/or one-year imprisonstri as well as civil penalties in the form of a STOP WORK ORDER and a line of up to$250.00 a day against the violator. lie advised that a copy of this statement may ba forwarded to the Office of Invcstigatiutts us'the DIA fur insurance coverage w:rilication /do hereby e'en/f r the pains uuJ pentisles of r ury that tire hrfararallen pros lded above is true and c orrecs. Si,rm tire& Dart, S IUJJic•ird use vn/y. Du not mitt in rids urrg to be raurplated by city ur to Cityor'ruwn: PermittLiccn:7 ___Nsuing,whorily(circle sac): I. lluarduC Ilealth 2.fluitd(ng Department 3.Citylfown Clerk 4. nspector 6.OtherContact Persons Pho - r CITY OF SiUI E„I, L LSSACHUSETTS 1 '• S _ BU[LDL\'G DEPARMENT h 130 WASHINGTON STREET, 3�Roca C TEL (978) 745-9595 Rtr(978) 740-9346 f<IJCBHRIEY DRISCOLL "+L4Yox THo.%Lu ST.PIERRa Dt.2ECTOR OF PUBLIC PROPERTY/Bt:ILDDjG COMMISSIONER Construction Debris Disposal Affidavit (required for all demolition and renovation work) In accordance with the sixth edition of the State Building Code, 730 CMR section l t 1.5 Debris, and the provisions of tbiGL c 40, S 54; Building Permit # is issued with the condition that the debris resulting from osed of in a properly licensed waste disposal facility as defined by MGL e this work shall be disp 111, S 150A. The debris will be transported by: &jypr- 2 UG K (name of hauler) The debris will be disposed of in (name of facility) _ CduM._�r.`AL S r L �� (address of raeilny) signaturo ofpa'mit applicant date — ❑bra..u'.�,n 7A O givi 7 CoLofti Melo's Construction LLC BBB 34 Jennings Circle Peabody,MA 01960 Krim Telephone: 978-531-0811 - E-mail: FaustinoMelonamsn.com n.w.dt.r MEMBER Faustino Melo,General Manager Unrestricted Mass Builders license No. 80393 Contractors Registration No. 108953 Proposal Submitted to: Phone ddiess: City,State,and Zip Code Fi1 ;.ur'_t irsn7 >`� r�/4t3td14 j0A. Job Description: Job location: UJ y)o2 Job Phone: We Proposed hereby to ficnia6mata ials and later•amplae toa s000nim wid,the spati6ra4ma listed tebw,far the nm of i1 I>'I—AI , t HCis1 5(A /) —'Trim Jr) J')C. ;iA done. Installation of Payments: Payments will be paid m thuds.The fast installment will be paid before the job begins:The second payment will be obtained in the middle of the job.The last payment will be obtained after the job is Pict �.�!� Note:This proposal may be witbdrawn by us Authorized Sigoauae: if not accepted within 20 days. Date: 'V—f 6— e Hereby Submit Sreetlfmtlom and Estimates M: THE INSTALLATION OF A NEW ROOF To protect the homeowners property,Blue Tarps will be used to cover the siding,bushes,and grass during stripping. All of the layers of roofing will be stripped,and all protruding nails,screws,and/or staples will be removed. Ice and water shield will then be installed at the bottom of all edges,around all chineys,skyl g and into all valleys. Fifteen(15)pounds of felt paper will be installed onto all other area of the roofdeck. The 8"Aluminum dripedge will then be installed to all roof edges. Any existing pipes will be covered with new tubber flanges. The roofing material to be used will be T i M 13 tY t2..0 itlJ i^ - A F The homeowner is responsible for the selection of the roof color. Also, the homeowner may select joer hand or pneumatic nailer•for the nailing application of the new roof. All the debris will be deaned and properlv.dispnsed of on a daily basis.Magnetic brooms will be used to extract an nails from your property. We will protect your property as best as we can,however,some foilage matting,breakage,or marring could occur.We cannot accept responsibihy for possessions inside of the house,or debris falling into attic areas. The customer should protect personal belo min si JLxtm work 10 which an additional cost Will be added to Me above Beim Replace Rotted Roofboards Gutter Repairs Remove Aluminum Siding Relead Chimney(a) Install Skylight(s) Remove Old/Rotted Wood Replace Facia Boards Repoint chimney Install Garage Roof Install Ridgevem Mate//Azek Board Install Insulation Install Roof Louvers Install Window Trim Install Tyvek Paper Install Aluminum Gutters Install Shutters Cover Aluminum Windows Install Aluminum Downspouts Remove Vmyl Siding Repair Vinyl Siding Install chimney cap Porch Repairs Rebuild Chimney Additional Notes: Total Amount for Additional Work: Warranty by manufacturer to be free of defects for a'Q years,see manufacturers warranty for details. All labor performed under this contract shall be of good quality and free from defects not inherent in the quality required or permitted for a period Of/(? years.This warranty excludes remedy for damage or defect caused by abuse,modification,improper or insuf5cem rnaitenance,improper operation,or normal wear and tear under normal usage. This warranty shall be limited to the work performed by Melds Construction,LLC and limited to either repair or replacement by Melds Construction,LLC at its sole deseretion and election.Any and all claims are waived unless made in writing to Melds Construction,LLC within 21 days after the occurrence of the event giving rise to such claim. This.warraaty shall not-attend beyond anyGmits imposed'by applicable=`,. Yaw r ._ r r rt { Payment and Penalties-Upon substantial completion of all work under this contract,customer shell-within 3 days-make the final and full payment of the contract price.Any and all unpaid balances shall accrue with interest at 5%interest per month. You agree to pay all court costs and collection expenses incurred by Melds Construction,LLC in the collection amount you Of any amount you owe under this contract,including and without any limitation of reasonable attorney fees. Acceptance of the Proposal: The above prices, specifications and conditions are satisfactory,and are hereby accepted. You are authorized to do the work as specified,payment will be made as outlined above. Payments are to made as per requisittion and or invoice. The proposal may be withdrawn within 20 days. �"�' �� Date of Acceptance: 0 11- - , 0 f sigaatore: (� r0 Pe 6147 C 7 0 Q / I/ y J